Comparison of Polyethylene Tibial Insert Damage from In Vivo Function and In Vitro Wear Simulation
Comparison of Polyethylene Tibial Insert Damage from In Vivo Function and In Vitro Wear Simulation
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DOI：
10.1002/jor.20743
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发表时间：
2009-04-01
影响因子：
2.8
通讯作者：
Hodge, W. Andrew
中科院分区：
文献类型：
--
作者：
Harman, Melinda K.;DesJardins, John;Hodge, W. Andrew
通过分析从患者（R组）中取出的聚乙烯胫骨垫片与体外力控制膝关节磨损模拟后获得的垫片的损坏模式，比较全膝关节置换术的功能和磨损。评估了两种模拟器输入配置文件，包括标准步行（W组）和步行和下楼梯相结合（W + S组），模拟各种活动和更严格的生理环境。对所有衬垫上的损坏区域进行定量评估。平均而言，所有组中的衬垫都有内旋损伤模式，外侧间室的关节变形最大。与W组相比，W + S组的这些模式更明显。模拟衬垫的变形率与大约6年的生理功能相似。然而，两组模拟衬垫通常低估了在取出衬垫上观察到的损伤面积和程度，这与模拟器胫股接触力学和功能活动期间已知患者发生的接触力学的差异一致。与标准输入相比，模拟器输入的修改（例如，W + S组中前后偏移增加和载荷条件更严格）可产生更大的磨损体积、更大的损伤面积和更高的表面变形率。(C)2008骨科研究学会。由Wile出版），期刊公司J Orthop Res 27：540-548，2009
Function and wear of total knee arthroplasties were compared by analysis of damage patterns on polyethylene tibial inserts retrieved from patients (Group R) with inserts obtained after in vitro force-controlled knee Joint wear simulation. Two simulator input profiles were evaluated, including standard walking (Group W), and combined walking and stair descent (Group W + S), simulating varied activities and a more severe physiological environment. Damage regions on all inserts were quantitatively assessed. On average, inserts in all groups had internally rotated damage patterns and the greatest articular deformation in the lateral compartment. These patterns were more pronounced in Group W + S compared to Group W. Deformation rates of simulated inserts were analogous to about six years of physiologic function. However, both groups of simulated inserts generally underestimated the magnitude of damage area and extent observed on retrieved inserts, consistent with differences in the simulator's tibiofemoral contact mechanics and those known to occur in patients during functional activities. Modification of simulator inputs, such as the increased anteroposterior excursion and more severe loading conditions in Group W + S, can generate greater wear volume, larger damage areas, and increased surface deformation rates compared to standard inputs. (C) 2008 Orthopaedic Research Society. Published by Wile.), Periodicals, Inc. J Orthop Res 27:540-548, 2009